Multiple Myeloma

Multiple myeloma is a type of cancer formed by malignant plasma cells. Normal plasma cells are an important part of the immune system. The immune system is composed of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. There are two types of lymphocytes: T cells and B cells.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells produce and release proteins called antibodies (or immunoglobulins) to attack and help kill disease-causing germs such as bacteria.

When plasma cells grow out of control, they can produce a tumor. These tumors can grow in several sites, particularly in the soft middle parts of bone marrow. When these tumors grow in multiple sites, they are referred to as multiple myeloma.

The overgrowth of plasma cells can interfere with the normal blood-forming functions of the bone marrow. This can result in a shortage of red blood cells and a condition called anemia. Anemia will cause fatigue. A shortage of blood platelets (cells that seal damaged blood vessels) can also occur. This can lead to excessive bleeding after cuts or scrapes. Another problem caused by an excess of plasma cells is leukopenia, a condition in which there is a shortage of normal infection-fighting white blood cells. A shortage of these cells causes decreased resistance to infections.

The abnormal plasma cells do not protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack specific infectious agents. For example, if you developed pneumonia normal plasma cells would produce antibodies that specifically attack and kill this type of bacteria. However, the antibodies produced by myeloma cells are not helpful in fighting infections.

Multiple myeloma is not the only disease involving excessive plasma cell growth. Two other forms of plasma cell disease are monoclonal gammopathy of undetermined significance (MGUS) and solitary plasmacytoma.

Solitary plasmacytoma is another category of plasma cell growth. Rather than multiple tumors in different locations as in multiple myeloma, there is only 1 tumor, hence the name “solitary” plasmacytomas.

Solitary plasmacytomas develop in bone marrow, or they may start in tissues other than bone marrow (such as the lungs or the lining of the sinuses, throat, or other organs). This is called extramedullary disease meaning outside the bone marrow. These tumors are treated by radiation therapy and/or sometimes with surgery. Their prognosis (outlook for recovery or survival) is usually excellent if no other plasmacytomas are found later on. However, most people with solitary plasmacytoma eventually develop multiple myeloma, especially if the plasmacytoma was in bone, and therefore need frequent examinations and tests to detect this progression as early as possible. Early treatment may lead to an improved outcome.

 


Signs, symptoms & indicators of Multiple Myeloma

Lab Values - Cells  

High ESR or elevated ESR




Conditions that suggest Multiple Myeloma

Circulation  


Hormones  

Hyperparathyroidism

When hyperparathyroidism is present, the likelihood of elevated serum calcium being caused by other conditions is obviously reduced.




Risk factors for Multiple Myeloma

Lab Values - Chemistries  

Hypercalcemia

High blood calcium levels are also related to advanced bone damage seen in multiple myeloma. Because bone normally contains lots of calcium, bone destruction releases calcium into the blood.

Less than 1% of cases of high calcium are due to cancer… far less than 0.01% of cases of high calcium in people sitting in front of their computer are due to cancer).

The types of cancer known to be associated with high blood calcium are:

Multiple Myeloma (this is discussed separately below).

Lung Cancer (squamous cell cancer of the lung, not all lung cancers)

Breast Cancer (advanced disease)

Kidney Cancer

Squamous Cell Cancer of the Head and Neck

Multiple Myeloma. Multiple myeloma is a cancer (it is in the list above), but we write more about it here because it is the most common cancer cause of high calcium. Nearly half of all people with myeloma have hypercalcemia at some stage during their disease. Multiple myeloma is a cancer of the plasma cells (a type of white blood cell) that are found in the bone marrow. Plasma cells develop from B lymphocytes (a different type of white blood cell) and they produce antibodies that help the body fight infection (bacteria and viruses). When a plasma cell becomes malignant it will divide many times and produce many copies of itself that form tumors in the bone marrow. Over a period of years these tumor erode the inside of the bone, producing holes in the bones (called “lytic” lesions). Since the malignant cells are clones they all act exactly alike and they all produce the same antibody molecule that is secreted into the blood (this is what your doctor will measure).

Multiple myeloma is often detected during routine wellness testing where it shows up as an abnormally high amount of protein in the blood, a high calcium level, and often increased amounts of protein in the urine. To make the diagnosis your doctor will order a protein electrophoresis to be done. This test will examine the proteins in your blood to see if there is a large amount of one type of antibody present… and if there is, the diagnosis of multiple myeloma is made.

About 15% of patients that we see for parathyroid disease have had protein electrophoresis test performed to make sure they don’t have multiple myeloma prior to them coming for treatment of their parathyroid disease. We believe that this is NOT necessary and this test is performed way too often. This is often done by endocrinologists who do not see parathyroid patients very often and they order a BUNCH of tests on your first visit (shotgun approach). Remember, almost everybody with high calcium will have parathyroid disease. If your doctor does not order a protein electrophoresis on your first visit, then good for them. You are almost guaranteed to never need it and you have a good doctor. [www.parathyroid.com]



Symptoms - Cancer  

History of multiple myeloma




Multiple Myeloma suggests the following may be present

Diet  

Dehydration

Most people with multiple myeloma need to drink a lot of fluid, as loss of fluid may cause kidney damage. You should drink two to three litres of fluid each day in the form of water.



The Immune System  

Weakened Immune System

Multiple myeloma is one of many conditions that can cause a weakened immune system.




Multiple Myeloma can lead to

Circulation  


Risks  



Recommendations for Multiple Myeloma

Botanical  

Turmeric Extract, Curcumin

Natural News reported in the fall of 2013, that “curcumin, the active ingredient in turmeric that is believed to provide the most therapeutic benefits, was found to be an effective weapon against multiple myeloma cells. Published in the peer-reviewed journal Organic & Biomolecular Chemistry, a recent study on this powerful compound verified that it is an effective medicine against not only multiple myeloma and other forms of cancer but also against cognitive degeneration and arthritis.

Other research has linked sulforaphane, an anticancer compound found naturally in broccoli and other cruciferous vegetables, to targeting multiple myeloma. Like turmeric, sulforaphane was shown to help enhance the effectiveness of existing chemotherapeutic agents, meaning conventional cancer treatments suddenly become more viable when paired with certain natural therapeutic agents.”



Drug  


Lab Tests/Rule-Outs  

Digestive Enzymes / (Trial)

166 subjects with multiple myeloma who took 2 Wobe-Mugos tablets (pancreatic enzymes) tid for the first year and then 1 tablet tid for the second year of the study, along with conventional treatement, experienced an extended lifespan (for stage III myeloma) from 47 months to 83 months over those who did not use the enzymes. The addition of oral enzyme therapy for more than 6 months reduced the hazard of death for patients at all stages of disease by approximately 60%. [Cancer Chemother Pharmacol, 2001;47(Supp1.):S38 S44 ]



Mineral  


Nutrient  


Vitamins  

Vitamin K1/K2

Many patients on high dose chemotherapy for lymphoma or myeloma test positive for prothrombin precursor PIVKA II. These are proteins induced by vitamin K absence or antagonism.



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended

Glossary

Cancer

Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Malignant

Dangerous. mainly used to describe a cancerous growth -- when used this way, it means the growth is cancerous and predisposed to spreading.

Immune System

A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Lymph

A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.

Protein

Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Antibody

A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.

Bacteria

Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.

Red Blood Cell

Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.

Anemia

A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Leukopenia

A condition in which the number of white blood cells circulating in the blood is abnormally low.

White Blood Cell

(WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.

Serum

The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Calcium

The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Hypercalcemia

Excess calcium in the blood.

Virus

Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.

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